Responding effectively to public health emergencies is a matter of law as well as medicine.
When such emergencies occur, there must be a legal structure in place that allows government and medical authorities to act quickly and comprehensively to implement quarantines and other safety and security measures, say experts in the public health field. But those legal mechanisms have not caught up with the heightened threat of bioterrorism and medical emergencies such as the 2003 outbreak of severe acute respiratory syndrome that spread to two dozen countries before being contained.
“You really are not going to have complete public health legal preparedness if the health care bar itself is not aligned with public health policy, practice and law,” says Anthony Moulton, co-director of the public health law program at the Centers for Disease Control and Prevention in Atlanta.
That is why the CDC welcomed a commitment by the ABA to raise awareness of lawyers about the threat of public health emergencies and to urge them to participate in efforts to develop effective responses.
The ABA’s policy-making House of Delegates adopted a recommendation in August that calls on bar associations and lawyers to become more involved in efforts to respond to public health emergencies.
“Public health law is one of those dormant areas of law that most lawyers, even health lawyers, don’t think very much about,” says Larry I. Palmer, who heads the Institute for Bioethics, Health Policy and Law at the University of Louisville School of Medicine. He also is a council member for the ABA Section of Health Law, which was lead sponsor of the measure the House adopted.
ABA and CDC officials also announced at the annual meeting that they will work in partnership to encourage public health groups and the legal community to develop cooperative approaches to strengthen the nation’s legal preparedness for responding to bioterrorism and other public health emergencies.
“The ABA and the CDC have now come together in some incredibly innovative ways,” says Myles V. Lynk, a law professor at Arizona State University in Tempe who chairs the Special Committee on Bioethics and the Law, a co-sponsor of the recommendation adopted by the House. That measure, says Lynk, “put the ABA on record as supporting greater public health awareness for lawyers, and urging state and local bar associations to train lawyers in public health emergencies.”
One of the first manifestations of the partnership between the ABA and the CDC is the Community Public Health Legal Preparedness Initiative. Under the initiative, lawyers and public health officials conduct community workshops about the legal aspects of responding to public health emergencies.
Model Act Gains Momentum
A key task in developing an appropriate legal framework for responding to public health emergencies is to update laws governing such actions, say experts in the field. Complicating that effort, they caution, is the fact that public health issues are addressed largely at the local level under laws adopted by the states.
“The reality is, in many cases, these laws as drafted in the states are antiquated” and might not even pass constitutional muster, says James G. Hodge Jr., executive director of the Center for Law and the Public’s Health at Georgetown University in Washington, D.C., and Johns Hopkins University in Baltimore.
In collaboration with the center, the CDC developed a Model State Emergency Health Powers Act. At least portions of the model act have been adopted in 33 states. “We’re really beginning to see a true development of a community of public health lawyers, public health improvement and reform,” says Hodge. “What you have in the end is a pretty powerful movement in the legal realm.”